Ave Maria Primary Care, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

AVE MARIA PRIMARY CARE, LLC

Practice address

5080 Annunciation Cir Unit 103
Ave Maria, FL 34142-9655

Phone

(239) 322-0917

Fax

(239) 658-5143

NPI assigned

Nov 12, 2024

Organization subpart

No

Name

Mrs. Carolina Mena

Title

Office Manager

Phone

(239) 322-0917

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raul G Enad, M.D.

  • Internal Medicine Physician
  • Ave Maria, FL
  • NPI 1659342079

  FL, Internal Medicine

  Medicare reassignment NPD

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 25, 2024.

{
    "created_epoch": "1731369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1962226381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5080 ANNUNCIATION CIR UNIT 103",
            "city": "AVE MARIA",
            "state": "FL",
            "postal_code": "341429655",
            "telephone_number": "239-322-0917",
            "fax_number": "239-658-5143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5080 ANNUNCIATION CIR UNIT 103",
            "city": "AVE MARIA",
            "state": "FL",
            "postal_code": "341429655",
            "telephone_number": "239-322-0917",
            "fax_number": "239-658-5143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVE MARIA PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-12",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A",
        "authorized_official_last_name": "MENA",
        "authorized_official_first_name": "CAROLINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "239-322-0917",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ave Maria Chiropractic
• Ave Maria Dentistry
• Ave Maria Hearing, Inc
• Ave Maria Hospitalist Group LLC
• Ave Maria Optical
• Ave Maria Speech Therapy & Napoli Therapy Services PA
• Martha Liliana Bedoya Leal, DDS
• Maribel Benavides, LCSW
• Kailen Berry, ATC
• Birthing Journeys LLC

• All providers in Ave Maria, FL
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.